High tolerance of progressive elastic compression in peripheral arterial disease.

Abstract

Background: Theoretically progressive compression stockings, which produce a higher compression at the calf than at the ankle level, improve venous return flow without exacerbating peripheral arterial insufficiency (PAD). We aimed to evaluate the short-term tolerance of elastic progressive compression stockings on peripheral arterial vascularisation in patients with symptomatic PAD and associated mild venous insufficiency. Patients and methods: Monocentric, prospective, open pilot study of 18 patients (acceptability study, 6x6 plan) evaluating the short-term tolerance of progressive compression stockings (18±2mmHgat calf and 8±2mmHgat ankle level) in patients with PAD (ankle brachial index ABI>0.60<0.75) and chronic venous insufficiency (C1s-C4 stages of the CEAP classification). Day 15 tolerance was evaluated by a composite primary criteria comprising: no decrease>15% of ABI on each side, no decrease>15% of toe brachial index (TBI) on each side and no decrease>25% of the number of active plantar flexions performed while standing. Results: The proportion of men was 77.8%, mean age was 77.3±7.5years and no patient were diabetic. At inclusion, the mean low ABI was 0.60±0.04 and the mean high ABI was 0.77±0.18. The mean low TBI was 0.32±0.09 and the mean high TBI 0.46±0.15. The mean number of active standing plantar flexions was 33.0±5.0. The majority of the patients were classified in CEAP C2s and C3 classes (class 2: 16.7%, class C2s: 27.8%, class C3: 44.4%, class C4: 5.6% and class C4s: 5.6%). Poor tolerance occurred in no patient. By day 30, no patient had worsening of their arterial and venous symptoms. No adverse events occurred during the study. Conclusions: These results suggest a high tolerance of progressive elastic stockings (18±2mmHgat calf and 8±2mmHgat ankle level) in symptomatic PAD.